Perioperative medicine & outcomes
The association of withholding or continuing angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers on acute kidney injury after non‐cardiac surgery
Main findingResult — go to the resultOdds ratio 1.16 95% CI 1.08–1.25Authors' conclusion
Continuing angiotensin-converting enzyme inhibitors or angiotensin 2 receptor blockers 24 h before non-cardiac surgery was associated with intra-operative hypotension and postoperative acute kidney injury.
Study context
- Population
- Patients prescribed ACE inhibitors or angiotensin 2 receptor blockers undergoing surgery > 1 h under general or spinal anaesthesia, single centre, January 2012 to June 2022
- Participants
- 32,933 patients · 8,631 matched pairs
- Exposure
- Continued vs Withheld
- Continuedn = 8,648
- Withheldn = 24,285reference
- Outcome
- AKI (creatinine increase ≥ 26.4 μmol.l-1)
- Follow-up
- First 48 postoperative hours
Methodological detailspropensity-score matched, single-centre
- Propensity-score matched
- Single-centre
Main finding
As reported in the abstract
Odds ratio
1.16
95% CI 1.08–1.25
P < 0.001
Events by group
Continued vs Withheld
OR 1.16 (95% CI 1.08–1.25); P < 0.001
Observational data: associations, not effects.
Further findings
Change in creatinine concentration
- Continuing drugs independently associated with mean increase in creatinine (p < 0.001)
- 2.2 μmol.l-1
Change in eGFR
- Continuing drugs independently associated with mean decrease in eGFR (p < 0.001)
- 1.4 ml.min.1.73 m-2
Safety
| Outcome | Continued | Withheld | OR (95% CI) | P value | |
|---|---|---|---|---|---|
| Intra-operative hypotensionPropensity-matched cohort | 45% | 39% | 1.28 (1.21–1.36) | P < 0.001 | |
| 0.512Odds ratio (log scale) |
Original publication
The association of withholding or continuing angiotensin‐converting enzyme inhibitors or angiotensin 2 receptor blockers on acute kidney injury after non‐cardiac surgery. Anaesthesia. Published 13 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →